Nurse Practitioner PruittHealth D-SNP

JOB PURPOSE:  In collaboration and consultation with physicians, staff RN's and other health care professionals, provides holistic, compassionate care to patients and families and provides care coordination and care management activities on behalf of the PruittHealth Premier Plan. Practices within the context of collaborative management with the physician(s) in diagnosing, managing, and preventing acute and chronic illness and disease, and promoting wellness. D-SNP Nurse Practitioners will visit members in their home as well as conduct telehealth visits for health risk assessments for new and post care transition members.  Nurse Practitioners have an advanced nursing practice that includes independent nursing functions based on nursing standards of care and a role in medical management working within a collaborative agreement with a physician(s).

KEY RESPONSIBILITIES:

1.     Proven ability to perform comprehensive, adult/geriatric admission history and physical exam

2.     Demonstrates ability to identify, diagnose and document episodic, acute and chronic disease in adults

3.     Demonstrates ability to recognize conditions, characteristics, and behaviors that place seniors at risk

4.     Proven ability to pursue feedback, continuing education and professional development

5.     Ability to effectively reconcile medications

6.     Demonstrates ability to identify and document the needs of clinically complex patients

7.     Work collaboratively with physicians, case managers, social workers, family members, key care givers and any appropriate ancillary medical personnel as appropriate

8.     Participates in Quality Assurance Performance Improvement (QAPI) activities

9.     Assesses the medical necessity/effectiveness of ancillary services to determine the appropriate initiation of benefit events and communicate the process to providers and appropriate team members

10.  Coordinates care as member's transition through different levels of care and care settings, ensures that the ICP is communicated immediately and/or no later than 24 hours to the receiving care setting